Pregnant? Treat your asthma seriously

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Breathe Easier

Federal experts have issued new guidelines advising women with asthma not to stop their medications during pregnancy. The guidelines, published in this month's Journal of Allergy and Clinical Immunology, call asthma drugs less of a risk to mother and fetus than asthma attacks. The advice is issued by a panel of the National Asthma Education and Prevention Program.

Taking It Seriously

An estimated 3.7 to 8.4 percent of pregnant women have asthma, an inflammation and constriction of the airways that can cause wheezing, coughing, chest tightness and difficulty breathing; the condition is often exacerbated by pregnancy.

"Many times people underestimate the severity of their disease because sometimes the changes (symptoms of asthma worsening) occur very gradually," said William Busse, panel chair and professor of medicine in allergy and immunology at the University of Wisconsin.

Mothers-to-be with asthma have increased risks of preeclampsia (a hypertensive condition), preterm birth and low-birth-weight babies, among other complications. The more that the asthma is under control, the lower the risk, says the new report. It recommends that patients avoid known asthma and allergy triggers and develop "stepped" treatment plans with their doctors, starting conservatively and increasing medication as warranted.

Drug Safety

The Food and Drug Administration lists several asthma drugs as category B medications (no harm to fetus shown by animal studies or studies in pregnant women), including budesonide (Pulmicort Turbuhaler), cromolyn (Intal), ipratropium bromide (Atrovent) and leukotriene receptor antagonists (Singulair or Accolate). The drug categories are being revised, so the panel did not rely heavily on them to produce its report. Data on some asthma drugs is sparse because many studies exclude pregnant women due to liability fears.